DRAFT 2011 -12 District Family Planning Plan

District: KALAHANDI

District Family Welfare Bureau Zilla Swasthya Samiti

KALAHANDI DISTRICT FAMILY PLANNING PLAN 2011 -12 1

KALAHANDI DISTRICT FAMILY PLANNING PLAN 2011-12 2

KALAHANDI DISTRICT FAMILY PLANNING PLAN 2011-12 3

Table of Contents Chapter Topics Chapter – 1 Background Chapter – 2 Situational Analyses a. Contraceptive Use b. Service Delivery c. Quality Assurance Mechanism d. Logistic and Supply System e. Human Resource Development

f. Communication Activities g. Private Sector Partnership h. Monitoring and Evaluation Chapter – 3 District Priorities as per the situations with respect to the State mandate. Chapter – 4 Family Planning Plan for the year 2011-12 a. Service Delivery b. Human Resource Development & Training c. Logistics and supply chain with requirement & distribution plan d. Communication Activities e. Private Sector Partnership f. Monitoring and Evaluation g. Any other (Innovations, Dist/Block/Sector specific) IEC, new plans etc. Chapter – 5 Resource Requirements

KALAHANDI DISTRICT FAMILY PLANNING PLAN 2011-12 4

Executive Summary –

Kalahandi district is situated in the southwestern portion of Orissa. Geographically this district lies between 19º 8’ N 20º 25’ N latitudes and 82 0 32 ’ E and 83 0 47’ E longitudes with geographical area of 7920 sq Km.

The population of the Kalahandi district as per the 2011 census is 157305; the sex ratio is 1003 per one thousand male. It has 13 blocks, 273 Grampanchayats, 2236 Rev villages (including 137 uninhabited villages), 13 Tahsils, and 2 Subdivisions. It has 4 towns Municipality, Junagarh & NAC and . Out of 13 blocks two are Tribal blocks1-Biswanathpur 2.Thuamulrampur. The blocks like ,B.N.Pur,M.Rampur,Bhawaniptna are having most difficult and high focus areas.The District is aware to its infant & Child mortalities due to communicable diseases like malaria,ARI,dirrhoea etc. as experienced previous years.

Experiencing in last couple of years, It has been observed that, the community of Kalahandi District is adopting only female sterilization operation. Decrease in progress of the sterilization,IUD,CC & OP in comparison to 2009-2010 due to short supply of CC & OP .There are 27 empanelled doctors in this year to conduct Sterilization operation, trained Para medical staff like LHV & ANMs to insert Cu T. It has been instructed to function fixed day static Centres in all the health institutions regularly, so that ELA for the year 2011-12 can be achieved.

The Rogi Kalyan Samiti (RKS), Gaon Kalyan Samiti (GKS) members are to be sensitised and utilize their services to provide F.P. services like sterilization operation, Cu.T, cases, C.C. & OP distribution. Now all the transaction relating to family planning supplies are tracked & monitored through the Central store the persons of central store have under gone orientation training of logistic supply, management, documentation and maintenance of records which gives good result.

This year plan is emphasizing to strengthen fixed day static centers for family planning with target to achieve 100% ELA in fixed day sessions in all L1,L2,L3 level .All empanelled doctors have been deployed to conduct the sterilization except ,, ,Parla and Kaksara CHC. The M.O. I/C of these institutions have been instructed to fix regular camps and intimate to the district for

KALAHANDI DISTRICT FAMILY PLANNING PLAN 2011-12 5 deployment of operating surgeons. The micro-plan in this regard have been finalized This year priority have been given to motivate NSV cases and arrange such camps to achieve the NSV target. A focus being given to popularize IUCD as a spacing method. The institution wise ELA for IUCD camps have been chalked out & trained IUCD inserters are instructed to insert the IUCD in the routine activities by motivating the beneficiaries. There is provision for incentives ASHA to motivate beneficiaries to retain IUCD and an amount of rs.100/- is earmarked per case.

The IUCD training programme is planned in which HW(F) & LHV will be trained in 2 nd qr. Of 2011. It is proposed to conduct training programme on NSV,Minilap at Dist.Hqr and proposal have been given to the state to train two O & G specialist in Laparoscopy.

Special attention will be given for wide publicity regarding regular functioning of FDS. Centre and wider publicity regarding the same among , ASHA, AWW along with the RKS & GKS members. The focus will be on spacing methods particularly IUCD Emphasis will be given on IUCD during population week & Family planning week. The review will be done institution wise regularly in District monthly meetings.

The District level quality assurance committee will be held regularly and discussed about the achievements as well as various deficiencies & difficulties to carried out the F.P.activities. The empanelled doctors list will be updated in the QAC meeting regularly..

KALAHANDI DISTRICT FAMILY PLANNING PLAN 2011-12 6

Chapter I

Background

The District Kalahandi is spread over an area of 7920 Sq. Kms. The population of the Kalahandi district as per the 2011 census is 157305, the sex ratio is 1003 per one thousand male. and child sex ratio is 947/1000 male. According to the census 2011, the literacy rate of male is 73.34 & female is 47.27.

Administratively the district is divided in to two subdivisions, namely Sadar Bhawanipatna & Dharamagarh. It has 13 blocks,273 Grampanchayats, 2236 Rev villages(includind 137un –inhabited villages),13 Tahsils, ,and 2 Subdivisions.It has 4 towns Bhawanipatna Muncipality,Junagarh& Kesinga NAC and Dharamgarh. Out of 13 blocks two are Tribal blocks1-Biswanathpur 2.Thuamulrampur. The blocks like Thuamul Rampur,B.N.Pur,M.Rampur,Bhawaniptna are having most difficult and high focus areas.The District is aware to its infant & Child mortalities due to communicable diseases likre malaria,ARI,dirrhoea etc. as experienced previous years.

No.of district Hqr Hospital 1

No.of blocks 13

No.of subdivisional Hospital 1

No.of CHCs 13

No.of PHC (New) 39

Other Hospitals 1

No.of Mobile Health units 14

Total No.of subcentres 273

Out of 273 sub centres nearly 76 are in the most vulnerable and hard to reach area.

KALAHANDI DISTRICT FAMILY PLANNING PLAN 2011-12 7

KALAHANDI DISTRICT FAMILY PLANNING PLAN 2011-12 8

Human Resource: Sanctioned Staff (Regular) Sl. No. Name of the Post Sanctioned In position 1 Asst. Surgeon 93 77 2 Staff Nurse 99 80 3 Pharmacist 78 75 3 MPHW(M) 178 176 4 MPHW(F) 282 267 5 MPHS(M) 59 55 6 MPHS(F)/LHV 45 35 7 L.T. 35 28 8 Radiographer 4 3 9 Specialists 83 36 10 ASHA 1613 1590 11 AWW 12 GKS 2040 2040

The above table clearly indicates that there are high vacancies in technical human resources. More ever the vacancies in rural areas are comparatively high. Contractual staff engaged under NRHM Sl Type of Personnel Sanctioned In position Vacant 1 DPM 1 1 0 2 DAM 1 1 0 3 DHIO 1 1 0 4 ASHA Coordinator 1 0 1 5 Hospital Manager 1 1 0 6 Staff Nurse 5 2 3 7 Additional ANM 80 75 5 8 LT 7 6 1 9 AYUSH doctor 51 40 11 10 Work Consultant (JE) 4 2 2 11 Immunization computer Asst 1 0 1 12 System In charge -cum -DEO 1 1 0 13 BPO 13 12 1 14 BPO at SDH 1 1 0 15 Block Account 13 13 0 20 Accountant at DHH/SDH 2 2 0 21 Accountant at AH 1 1 0 22 MCH Coordinator 1 1 0 23 Child Health Coordinator (NIPI) 0 0 0 24 Routine Immunization Coordinator 0 0 0 Yashoda Supervisors (NIPI) 0 0 25 0 26 YASHODA (NIPI) 6 6 0 27 MHU personnel 28 LT RNTCP 7 6 1 29 Pharmacist-Cum-Store Keeper 1 1 0

KALAHANDI DISTRICT FAMILY PLANNING PLAN 2011-12 9

Chapter II :

Situational Analysis: In Kalahandi district only female sterilization operation is adopted by the community to limit the family.

Family Planning performance in the Kalahandi in percentage GRAPH ON ORAL

GRAPH ON STERILISATION OPERATION PERFORMANCE

PILLS PE RFORMANCE

GRAPH ON I.U.D. PERFORMANCE

GRAPH ON CONTRA CEPTIVES PERFORMANCE

KALAHANDI DISTRICT FAMILY PLANNING PLAN 2011 -12 10

F.W. 2008-2009 2009-2010 2010-2011 2007-2008 Activities Target Ach. % Target Ach. % Target Ach. % Target Ach. % Sterilization 5197 5854 113% 5771 4675 81% 5817 5188 89% 5842 4814 82% IUD 3740 3745 100% 4231 2657 63% 4031 3202 80% 6526 3318 51% CC 6690 5639 84% 6747 4396 65% 6175 4434 72% 13085 4023 31% Oral Pill 5664 3225 92% 5702 4550 80% 5714 3842 67% 7707 4159 54%

Institution wise Family Planning Performance of Kalahandi District per 1000 poipulation for the Year 2009-2010 on sterilisation,IUCD,CC & OP Sterilization IUCD OP CC Accep Accepto Accepto Accept tors Sl. Total Total rs Per Total rs Per Total ors Per Block Per No. Accep Accep 1000 Accep 1000 Accep 1000 1000 tors tors Populat tors Populat tors Popula Popul ion ion tion ation 1 B.N.Pur 331 3 212 2 285 3 340 3 2 Borda 361 4 261 3 162 2 553 6 3 Karlamunda 288 3 84 1 178 2 151 2 4 M.Rampur 201 2 230 2 160 2 118 1 5 434 4 425 4 350 4 564 6 6 Pastikudi 502 5 347 4 271 3 201 2 7 Th.Rampur 200 2 134 1 127 1 65 1 8 Junagarh 573 6 361 4 302 3 383 4 9 Chapuria 500 5 312 3 327 3 176 2 10 Jaipatna 279 3 282 3 254 3 154 2 11 Kalampur 240 2 27 1 146 1 151 2 12 458 5 122 1 186 2 388 4 13 Parla 340 3 175 2 274 3 340 3 14 Bh.Patna PPC 213 2 48 1 561 6 510 5 15 Dh.garh PPC 160 2 97 1 180 2 258 3 16 Junagarh PPC 132 1 92 1 79 1 82 1 TOTAL 5212 52 3209 34 3842 41 4434 47

KALAHANDI DISTRICT FAMILY PLANNING PLAN 2011-12 11

Family Planning Performance of Kalahandi District for the Year 2010-2011 Sterilization IUCD OP CC Acce Accep Accept Accept ptors tors Sl. Total Total ors Per Total ors Per Total Block Per Per No. Acce Acce 1000 Acce 1000 Acce 1000 1000 ptors ptors Popula ptors Popula ptors Popul Popul tion tion ation ation 1 B.N.Pur 334 3 270 3 185 2 243 2 2 Borda 286 3 158 2 134 1 161 2 3 Karlamunda 266 3 98 1 177 2 196 2 4 M.Rampur 283 3 192 2 239 2 188 2 5 Narla 342 3 295 3 307 3 418 4 6 Pastikudi 501 5 307 3 63 1 197 2 7 Th.Rampur 179 2 217 2 262 3 134 1 8 Junagarh 520 5 324 3 181 2 188 2 9 Chapuria 516 5 465 5 380 4 506 5 10 Jaipatna 196 2 340 3 467 5 345 3 11 Kalampur 166 2 66 1 130 1 68 1 12 Koksara 391 4 123 1 384 4 310 3 13 Parla 355 4 198 2 293 3 248 2 14 Bh.Patna PPC 254 3 125 1 497 5 496 5 15 Dh.garh PPC 146 1 115 1 260 3 235 2 16 Junagarh PPC 79 1 25 1 200 2 90 1 TOTAL 4814 49 3318 34 4159 43 4023 39

KALAHANDI DISTRICT FAMILY PLANNING PLAN 2011-12 12

DLHS-II & DLHS-III comparison

DLHS III DLHS II Marriage & Fertility Total Rural Total Rural Percentage of girl's marrying before 29.9 30.8 25.9 36.8 completing 18 years Percentage of Births of Order 3 and above 41.8 41.8 48.5 49.6 Percentage of women age 20 -24 reporting 51.7 50.3 - - birth of order 2 & above Percentage of birth to women during age 4.2 4.6 - - 15-19 out of total births Family Planning Any Method (%) 28.9 28.6 44.5 34.8 Any modern method (%) 27.8 27.7 33.9 25.3

Female Sterilization (%) 19.8 19.5 25.7 21.6 Male Sterilization (%) 0.2 0.3 0.0 0.0 IUD (%) 0.4 0.4 0.4 0.0 Pill (%) 6.8 6.8 5.4 3.5 Condom (%) 0.6 0.6 2.4 0.3 Unmet need for Family Planning Total unmet need (%) 34.9 34.8 18.8 19.6 For Spacing (%) 14.2 14.3 5.6 5.8 For limiting (%) 20.7 20.5 13.2 13.8

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d. Service Delivery:-

Over all No. of Achievement Total performan Functio in FDS (2010- Achieveme Achievemen ces Vs Rem nal FDS 11) in Fixed nt in Block t of the FDS center arks Centres days in Camps Block in No. coverage (2010- number (%) 11) St. IUCD St. IUCD St. IUCD St. IUCD B.N.Pur 2 0 270 334 0 334 270 100 73 Borden 1 146 158 140 0 286 158 59 23 Karlamunda 1 266 98 0 0 266 98 88 43 M.Rampur 1 275 192 8 0 283 192 85 62 Narla 1 342 295 0 0 342 295 75 60 Pastikudi 2 185 307 316 0 501 307 103 56 Th.Rampur 1 0 217 179 0 179 217 60 65 Junagarh 1 520 324 0 0 520 324 111 48 Chapuria 1 516 465 0 0 516 465 107 85 Jaipatna 1 64 340 132 0 196 340 43 67 Kalampur 1 0 66 166 0 166 66 53 26 Koksara 1 0 123 391 0 391 123 85 24 Parla 1 355 198 0 0 355 198 79 35 Bh.Patna PPC 1 254 125 0 0 254 125 92 46 Dh.garh PPC 1 146 115 0 0 146 115 114 110 Junagarh PPC 1 79 25 0 0 79 25 68 19 TOTAL 18 3148 3318 1666 0 4814 3318 82 51

It is observed from the above table that insertion of IUCD is 51% in last year however more concentration like IUCD training to paramedics, doctors is to be taken up simultaneously, special awareness regarding IUCD to be organized in low performing blocks with an objective to more coverage & bringing IUCD acceptors to the premises of FDS

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e) Post Partum & Post abortion Contraception

JSY (Janani Surakshya Yojana) acted as an catalyst has increased the institutional delivery from 33% in 2005 to 65% in 2010. The progress was due to the additional interventions like referral transportation facility, Janani express, night ambulances etc. Out of the total 65% institutional delivery in the district, 10018 nos. of deliveries have been conducted in L3 institutions level and only 173(1.72%) nos. of PPS cases have been conducted. Our special focus on PPS at L3 level will be at least 5% of the total institutional delivery in 2011-12. f) Service Environment

At present there are 27 empanelled doctors who will conduct sterilization operation. The involvement and participation of members of Rogi Kalyan Samiti, (RKS) Gaon Kalyan Samiti (GKS) and other stake holders was negligible .In this year they have been oriented & engaged in facilitating to strengthen the fixed day service delivery centers on family planning by providing pertinent support. In this year two O & G specialist will be sent to state level to undergo laparoscopic training.

The minilap kits, IUCD insertion kits are to be supplied as per requirement. The sterilization operation application forms etc are supplied by the state which is in sufficient. It should be supplied as per the ELA 2011-12. It has been seen that cases coming for sterilization operation are to be done so many tests before sterilization, which is very expensive & operation cases are paying the same. Therefore the state authority should think on it & create provision so that the expenditure towards tests prior to sterilization would not be a problem to undergo sterilization operation. Again Sterilizers, gloves, medicines, logistics other essentials requires to be supplied sufficiently for improvement of quality service delivery. g ) Quality Assurance Process

Government has most importance to the Quality assurance Committee in family Planning aspects. As per the Honorable Supreme Court directives, it has been clearly outline the structure, institutional arrangement, role and responsibility and significance of the Quality assurance Committee. In this year there will be four QAC KALAHANDI DISTRICT FAMILY PLANNING PLAN 2011-12 15

meeting in which, the members will be oriented regarding their roles and responsibilities.

A. Logistics and Supply system

CC OCP IUCD Qr. Mini. Max. Stock Mini. Max. Stock Mini. Max. Stock Stock Stock Out Stock Stock Out Stock Stock Out Qr 1 65173 79655 0 67621 82103 0 52483 66965 0

Qr 2 65173 79655 0 67621 82103 0 52483 66965 0

Qr 3 65173 79655 0 67621 82103 0 52483 66965 0

Qr 4 65173 79655 0 67621 82103 0 52483 66965 0 Presently all the transactions relating to the family planning supplies are tracked and monitored through the central store. The ProMIS being made functional and operational for the family planning supplies. The orientation and training to the concern personnel on logistics supply, management, and documentation are paying good dividends.

i) Communication Activities No specific activities aiming family planning was conducted as per the planed last year. The communication activities focusing family planning was carried out during the population week, before the plan developed. As the RKS and GKS were not involved and informed relating to the FP services, However in this year they have been involved & expected some progress made by them on this regard.

j) Private Sector Partnership

No private institution has been accredited to provide family planning services till date. The LIFE WORTH Hospital Bhawanipatna has already been inspected by the Dist. Level committee for accreditation. Again, another application of Uma clinic Kesinga has been received and will be inspected by the Dist. Level committee by end of june,11. After finalization of these institutions as per guideline, they will be accredited for the sterilization operation cases.

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B. Human Resource Development Total number of empanelled surgeons at the district and their respective place of posting.

No. of sterilization Category operation conducted

Sl. Presently posted Of Name of the Surgeon during the 2010-11 No Institute Remark

(L1/L2/L3)

Vasect omy NSV Minila p Lapar oscop y Dr. Puspansu Sahu 1 PPC, Bh.Patna L3 0 2 252 MS O & G Dr. Giridhari Pradhan 2 PPC, Bh.Patna L3 0 52 MS O & G Dr. P.K. 3 DHH, Bh.Patna L3 0 - MS GS Dr. A.K. Negi 4 SDH, Dh.garh L3 0 7 MS O & G Dr. S.N. Panigrahi 5 SDH, Dh.garh L3 0 1381 MS O &G Dr. R.K. Gantayat, 6 SDH, Dh.garh L3 0 407 MBBS

Dr. M.K. Tripathy UGPHC, 7 L2 0 34 MBBS B.N.Pur

Dr. Amar Ku. Behera UGPHC, 8 L2 0 50 MBBS B.N.Pur Dr. Mano Majhi 9 CHC, Borda L2 0 83 MBBS Dr. Debanand Bhoi PHC (N), 10 L2 0 100 MS GS Karlapada

Dr. B.K. Rout CHC, 11 L2 0 266 MBBS Karlamunda

12 Dr. A.K. Agrawal CHC, M.Rampur L3 0 632

KALAHANDI DISTRICT FAMILY PLANNING PLAN 2011-12 17

MBBS

Dr. P.K. Sahu CHC, 13 L2 0 341 MBBS Narla DR. M.K. Panda 14 CHC, Pastikudi L2 0 138 MBBS Dr. Hemangini Meher 15 CHC, Pastikudi L2 0 16 MS O&G Dr. P.C. Sahu PHC (N), 16 L2 0 301 MBBS Kandel Dr. Kambupani Naik 17 AH, Kesinga L3 0 3 29 MS O&G Dr. Rameswar Mohanty 18 AH, Kesinga L3 0 - MS GS CHC, 19 Dr. Biswajit Sahu, MBBS L2 0 - Th.Rampur Dr. Labanya Prabha 20 CHC, Junagarh L3 0 5 Mund O&G Dr. Sanjaya Ku. Behera 21 CHC, Junagarh L3 0 - MBBS Dr. Bhagaban Panda 22 PPC, Junagarh L2 0 - MD Paed. 23 Dr. Satyasai Naik, MBBS CHC, Chapuria L2 0 544 Dr. P.K. Sukla PHC (N), 24 L2 0 - MBBS Ladugaon Dr. S.K. Naik - 25 CHC, Parla L2 0 MBBS Dr. Madan Mohan 26 CHC, Junagarh L3 0 9 - Tripathy, Spl. Paed. 27 Dr. N. Udgata SDH, Dh.garh L3 0 12

KALAHANDI DISTRICT FAMILY PLANNING PLAN 2011-12 18

C. Monitoring and Evaluation

Monitoring and supervision needs to be targeted. The poor performances in the fixed day static centers, occasional meeting of quality assurance committee, O&G specialists not conducting sterilization operation can be attributed to poor supervision and monitoring.

At present the review of family planning is done as the part of regular monthly meeting, but there is no specific regular review on it. The BPO, SA and BEE orientation on family planning data analysis and interpretation conducted during last year with the support of UNFPA and SFW Cell was an eye opener to the reporting staff.

KALAHANDI DISTRICT FAMILY PLANNING PLAN 2011-12 19

CHAPTER-III

DISTRICT PRIORITIES

Basing on the present situation, the district health administration has decided to prioritize the following activities to strengthen the family planning programme this year.

1. Strengthening fixed day static Centers for family planning with target to sustain the last year achievement I,e upto 82% in Fixed Day sessions in all levels of MCH Centers.

2. Focused attention for sterilization operation in the institutions having O&G specialists in position.

3. Post partum sterilization to be increased during this year.

4. Activating QACs and strengthening monitoring and supervision.

5. Promoting male sterilization by involvement of NGOs ,ASHSAs,&GKS members.

6. Corporate sector involvement and support to improve family planning under PPP initiatives.

7. Enumeration of eligible couple and wider publicity to popularize and acceptance of IUCD, through ASHA and other community volunteers and volunteers of Nehru Yuba Kendra (NYK), Volunteers of PPP NGO who are managing PHC(N) management recently selected partner NGOs for GKS capacity building through Nodal agency CARE , Orissa.

8. Involvement of ASHA and AWWs in popularizing the small family norm by sensitizing them regarding various spacing methods and supporting them as non-clinical contraceptive depot holders.

9. Gearing up FW services provided by the PPCs and as center of family welfare and planning activities.

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Chapter IV :

FAMILY PLANNING PLAN FOR THE YEAR 2011-12 :-

ELA for 2011 – 12 for all methods in a table along with block wise break up :-

PLAN OF FAMILY WELFARE ACTIVITIES OF KALAHANDI DISTRICT FOR THE YEAR 2011-12 (As per ELA)

S.T IUD CC OP Population Institution (2011-12) Target Target Target Target 11-12 11-12 11-12 11-12 B.N.Pur CHC 89296 335 404 813 478 Borda CHC 169300 516 711 1461 863 Karlamunda PHC 59040 284 262 527 310 M.Rampur CHC 82054 334 342 688 405 Narla CHC 122392 455 525 1054 620 Pastikudi CHC 142357 487 579 1227 722 Th.Rampur CHC 83783 268 366 735 432 Junagarh CHC 171698 538 715 1491 878 Chapuria CHC 128591 485 577 1160 682 Jaipatna CHC 129412 408 541 1087 640 Kalampur PHC 61958 296 291 585 344 Koksara CHC 119380 458 537 1079 635 Parla PHC 122896 461 596 1198 705 Junagarh PPC 18958 130 164 217 131 Dh.garh PPC 13888 119 145 180 112 Bh.patna PPC 68507 275 306 650 382

Total District 1583510 5849 7061 14152 8339

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ELIGIBLE COUPLE FOR THE YEAR 2011-12 OF KALAHANDI DISTRICT.

Name of the Block/ Sl. Urban Area Health 15-19 20-24 25-29 30-34 35-39 40-44 45-49 No. Institution Years Years Years Years Years Years Years

1 BISWANATHPUR 1430 2145 3575 4468 2681 1787 1787 2 BORDA 2709 4063 6772 8465 5079 3386 3386 3 KARLAMUNDA 945 1417 2362 2952 1771 1181 1181 4 M.RAMPUR 1313 1969 3282 4103 2462 1641 1641 5 NARLA 1958 2937 4896 6120 3672 2448 2448 6 PASTIKUDI 2278 3417 5694 7118 4271 2847 2847 7 TH.RAMPUR 1341 2011 3351 4189 2514 1676 1676 8 JUNAGARH 2747 4121 6868 8585 5151 3434 3434 9 CHAPURIA 2057 3086 5144 6430 3858 2572 2572 10 JAIPATNA 2071 3106 5176 6471 3882 2588 2588 11 KALAMPUR 991 1487 2478 3098 1859 1239 1239 12 KOKSARA 1910 2865 4775 5969 3581 2388 2388 13 PARLA 1966 2949 4916 6145 3687 2458 2458 14 DHARMAGARH PPC 222 333 556 695 417 278 278 15 JUNAGARH PPC 303 455 758 948 569 379 379 16 BHAWANIPATNA PPC 1096 1644 2740 3425 2055 1370 1370 District Total 25337 38005 63343 79181 47509 31672 31672

To achieve the ELA for the year 2011-12 annual requirement of contraceptives etc. have been sent to the DFW, Orissa, vide Letter No.817/ Dt.21.05.2011 as follows.

Sl. Opening Balance as ELA for the year Annual Items No. on 01/04/11 2011-12 Requirement 1 OCP (in cycles) 2880 8339 110947 2 Condom (in pieces) 219300 14152 901538 3 CuT.-380-A (in pieces 48000 7061 5967 4 Tubal rings (in pairs) 0 0 0

KALAHANDI DISTRICT FAMILY PLANNING PLAN 2011-12 22

A. Service Delivery Plan

Please mention what plan is for Institution wise fixed day Sterilization FDS/Camps is planned for the year 2011-12 is given below. No. of St.Operation in St. Operation in FDS Sl. Name of the Camp Name of the Operating No. Institution 1st 2nd 3rd 4th 1st 2nd 3rd 4th Surgeon Qr. Qr. Qr. Qr. Qr. Qr. Qr. Qr. 1 B.N.Pur 0 172 112 111 0 0 0 0 Dr. M.K. Tripathy

2 Borda 0 264 172 171 0 0 0 0 Dr. Mono Majhi/ Dr. D.N. Bhoi 3 Karlamunda 0 0 0 0 146 146 95 94 Operating surgeon to be arranged 4 M.Rampur 0 171 111 110 0 0 0 0 Dr. A.K. Agrawal 5 Narla 1 233 152 151 0 0 0 0 Dr. P.C. Sahu 6 Pastikudi 0 250 162 161 0 0 0 0 Dr. P.C. Sahu 7 Th.Rampur 0 0 0 0 0 138 89 88 Dr. Biswajit Sahu

8 Junagarh 0 0 0 0 0 275 179 178 Operating surgeon to be arranged 9 Chapuria 0 249 162 135 0 0 0 0 Dr. Satyasai Naik

10 Jaipatna 0 0 0 0 0 209 136 135 Operating surgeon to be arranged 11 Kalampur 0 0 0 0 0 151 99 98 Operating surgeon to be arranged 12 Koksara 0 0 0 0 0 235 153 152 Operating surgeon to be arranged 13 Parla 0 0 0 0 0 236 154 152 Operating surgeon to be arranged 14 Bh.Patna 11 141 92 91 0 0 0 0 Dr. Puspansu Sahu/ PPC Dr. L.P. Mund 15 Dh.garh 0 68 43 43 0 0 0 0 Dr. S. Panigrahi/ PPC Dr. A.K. Negi 16 Junagarh 0 0 0 0 0 62 40 40 Operating surgeon to PPC be arranged

KALAHANDI DISTRICT FAMILY PLANNING PLAN 2011-12 23

i. During second quarter total 51.29 percent i.e 300 sterilisation cases will proposed to be conducted as special/ drive will be carried out in the occasion of World Population Fortnight. During second and third quarter 33.33 and 32.65 percent i.e 1950 &1910 nos sterilisation cases proposed to be operated in FDS and Camps. ii. Service Delivery Plan to popularize IUCD in the district. iii. Plan for improving access to information and availability of OP and CC through engagement of ASHA’s and AWW.

B. Human Resource Development Plan :-

Please mention about Plan for HRD :- It is evedent that only nine institutions are providing fixed day static services on family planning services That too also in a partial manner as there is hardly any IUCD insertion and other family planning services provided at the institution level. There is one L3 ( AH Kesinga seven L2 institution and twenty eight L1 institutions to provide the services at least in a fixed day. This year it is proposed to make all the levels 1, 2 & 3 providind requisite family planning services in a fixed day. Deficits to be Sl. Category Name of the addressed for Time line No (L1/L2/L3) Institution making FDS & personnel responsible center functional Dharmagarh, Laparoscopic and State level NSV trained 01 L3 M.Rampur human resource CHC and

Kesinga AH are to be placed at the instition to

provide all the manded services.

List of doctors in ADMO(FW),DPM, MOi/c the institutions are to be empanelled by the district QACs

KALAHANDI DISTRICT FAMILY PLANNING PLAN 2011-12 24

for providing fixed

day services, other empanelled doctor to be mobilized accordingly FDS centre in all level

Three laparoscope machine may be plaaed for procurement Equip: alongwith Minilap kits, NSV kits and IUCD insertion kit.

Action ADMO(FW)and DPM

Poor response in the fixed day as IEC there is a need for wide publicity Action; MO I/C and BEE

Logistic and drugs alongwith insurance coverage should be in Others proper away.

Action : MO i/C, and BPO

L2 (19 Empanelment of doctors at the institutions) institution for minilap

But some trained doctors of Jaipatna,Koksara,Parla,Kalampur,

HR(Training) Th.Rampur etc. are not performing sterilization operation.

Action ADMO(FW) and CDMO.

KALAHANDI DISTRICT FAMILY PLANNING PLAN 2011-12 25

Procurement of sterilization equipments, IUCD, NSV Kit and

Other essential as per the requirement by the respective RKS from fund allocated in the Equipment PIP/ or by respective RKS and

Untied fund. Replacement may be made as and when required.

Action: MOI/C and respective RKS by 30 th .June-2011.

Publicity regarding the provisions and fixed day sites as per the IEC State mandate by respective BEE and BPO.

Action: BEE/BPO

Monitoring of progress on FDS at monthly meetings and quarterly Others review meeting at district level and visit by QAC members.

3 L1(32) 12- Sub-Centres (Seinpur, Medinipur,Jugsaipatna, Kutrukhamar, Rengalpali, HR(Training)Total Champadeipur, Bijepur, Malipada, 64 ANMs will be Domkarlakhunta, Urladani, imparted training Sergarh and Dumerpadar in a phased 20- PHC (N) (Karlapada, Artal, manner. Tipiguda, Farang, , Dhansuli, Deydar, Charbahal, Habaspur, Kandel, Barabandha,

KALAHANDI DISTRICT FAMILY PLANNING PLAN 2011-12 26

Belkhandi, Road, Madhupur, Bengaon, Mohangiri, Rupra Road, Rupra, Nakrundi and Adri

All the concerned ANMs to be trained on IUCD. IUCD kit and related essentials logistics to be procured by ANM from her Untied fund . In case of PHC(N) the fund

Will be met from RKS.

Action: DPM and respective MOI/C in consultation with ADMO(FW).

4. Besides strengthening the fixed day static centres special camps to be organized in at respective PHC(N) in an quarterly manner as per the budget provisions because of the shortage of operating surgeons. District also organizing IUD insertion mela once in a month by LHV to mobilize resources from corporate sectors to organize such sterilization camps in PHC(N) located in inaccessible pockets and in low performing blocks by tracking progress of each BPHC after each quarterly review meeting. Action: ADMO(FW) and DPM 5. Observation of World Population Day during July-2011. Action: ADMO(FW) and DPM 6. Special Plan by identifying mothers with in the age group of 25 having single child to motivate them to accept IUCD through tracking by ASHAs with the support of ANMs by monitoring SC wise target. Action: MOI/C, BEE and BPO. 7.HW(M)/(F), ASHAs and AWWs to be motivator and depot holders of non clinical contraceptives .Regular sector and monthly meeting. Action: Health Supervisors, BEE and BPO.

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Human Resource Development Plan (T raining Plan) District Sl. Training State Level Name and Designation Level No. Required Intervention Intervention Dr. Rameswar Mohanty, MS NSV State Kausik Sarangi, Mini-Lap District Asst. Surgeon,CHC-1, L3 M.Rampur Dr. Sadananda Panigrahi and Laparoscopic State team, SDH, Dharmagarh Doctors, Staff Nurses IUCD District Dr. Debendra Bhoi, Asst. District Surgeon, Karlapada NSV Dr. Malaya Kumar Tripathy, NSV District MO I/C, CHC, Biswanathpur Dr. S.S. Naik, Asst. Surgeon. NSV District Dr. P.C. Sahu, MO I/C, CHC, NSV District Pastikudi. Dr. Baroda Kanta Mishra, MO Mini-Lap District I/C, CHC, Karlamunda Dr. Manoj Kumar Parida Mini-Lap District PHC Kalampur L2 Dr. Abhisek Sahu, Asst. Mini-Lap District Surgeon, Rupra Dr. Alok Kumar Jena, Asst. Mini-Lap District Surgeon, CHC, Chapuria. Dr. Ranjan Kumar Mishra, Mini-Lap District Asst. Surgeon, Borda. Doctors, Staff Nurses, LHV IUCD District Doctors Contraceptive District Updates Paramedics Contraceptive District Updates All the concerned ANM of IUCD District L1 designated PHC(N) and SC

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Training Calendar for Family Planning Services -2011-12: Total Person Q1 Q2 Q3 Q4 target responsible IUCD 2 2 MEIO Minilap 1 1 MEIO Contraceptive update(doctors) 1 MEIO Contraceptive update(paramedics) 2 2 MEIO Programme Guideline orientation MEIO Logistics & Supply chain 2 2 MEIO management MTP 1 MEIO Orientation of AWW and ASHA 39 39 MEIO regarding Spacing Method Computer Training to Data 1 DHIO Handler of cold chain handlers SA, BEE etc.

C. Service Environment Strengthening Plan :- The requirement of equipment and instruments for Family Planning Services with justification. Process of Sl. Level of Equipment/Instrument Numbers Procurement No. Institute District State 1 L3 NSV Set 10 Dist. (CDMO) Artery Forceps 150 - Do - Allis Forceps 150 - Do - Needle holder 125 - Do - Sponge holder 100 - Do - Babcock’s forceps 150 - Do -

Laproscope with CO 2 2 - Do - 2 L2 NSV Set 8 - Do - Artery Forceps 75 - Do - Allis Forceps 75 - Do - Needle holder 60 - Do -

KALAHANDI DISTRICT FAMILY PLANNING PLAN 2011-12 29

Sponge holder 50 - Do - Babcock’s forceps 75 - Do -

Laproscope with CO 2

D. Logistics and Supply System It is observed during the previous years that there is hardly any system of record, documentation and systematic management of supply and logistics issues pertaining to the family planning stock. With efforts from the state Family welfare cell, the progress was observed and the difference was felt. Presently all the family planning supplies are received and distributed from the district central store and data is regularly updated in to ProMIS.

A system of indenting and monitoring of supply of family planning materials to the grass route is planned. This year the proposal is to make the logistics and supply chain management more transparent. It is planned to integrate with the general system and pertinent steps for proper indenting, distribution so that things to reach the point where it is badly needed.

Involvement of ASHA and AWWs as a non-clinical contraceptive depot holder and popularizing the small family norm through birth spacing will be the concern of the district health administration. Through ASHAs and AWWs the district plans to maintain contraceptive security by enhancing access to the community.

The annual requirement for the year is given below.

Sl. Annual Method Stock No. Requirement 1. IUCD 4800 5967 2. OP 2880 110947 3. CC 219300 901538 4. Tubal Rings 0 0

According to the district NRHM, Programme Implementation plan there is provision of transportation support towards distribution of the family planning materials and supplies. All the receipt and debit account of family planning supply will be

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monitored through ProMIS and district is awaiting the support from state relating to the monitoring of distribution and supply of FP materials through SMS messaging from subcenters.The family planning supplies will be distributed as per plan in a bimonthly basis.

E. Quality assurance Plan

Last year there is only one meeting of QAC in the district. This year it was planned to have regular QAC meeting to update the empanelled doctors list for sterilization operation and perform the assigned duty of facility audit, exit interview, access quality relating to prudent clinical practices. It is also agreed to have the QAC meeting in every third Friday of the first month of the quarter. That is on 3rd Friday of April, July, Oct. and January 2012. Also it can discuss as and when require.

Action: MCH Coordinator & ADMO (FW)

F. ELCO Survey :

Eligible Couple serves the basis of the family planning programme and interventions. The last headcount and detail assessment of the eligible couples was done every year, Since then there was only annual updation. This year also conducting the Eligible Couple survey from 1 st April,11 by involving the ASHA, AWWS and Health Worker (Male and Females).

Action: DPM, ADMO (FW), MOI/C, BEE & BPO

G. Communication Activities:

Besides the regular IEC activities, the programmatic intervention based IEC is a dire need to expand family planning services at the present scenario.

1. Orientation of RKS and GKS members on advantages of family planning, the requirement for facility up gradation, fixed day static center approach and the quality aspects and role of RKS for betterment of patients and clients.

2. Sensitization of the NYK volunteers/ppp NGO volunteers/community youth leader/selected ASHAs/ regarding the fertility issues and programme intervention.

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3. Display boards in front of the PPCs citing about the provisions for the family planning methods as an information kiosk.

4. Wide publicity through banner, poster, wall paintings about the FDS centers, provisions and incentives in family planning programmes.

H. Monitoring & Supervision :

1. Periodic monitoring and field visit by the district officials and QAC members to access facility, exit interview and verification of records and registers.

2. Tracking the progress through facility based reporting and action towards non reporting of the units.

1. Quarterly review of Family planning programmes and institutionalizing the QAC meeting in every quarter.

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Chapter V

Resource Requirement:

Please mention available resources to meet out requirements of Family Planning Plan as well as additional resources required to achieve program objectives. Task Sl.No. 2011-12 Time Frame budgetin PIP Responsibility MajorActivity Presentproposed Opeartionalization June 2011 ADMO(FW)/MOI 68.87 of fixed day FP /cs services Publicity on FDS All the year Respective To be included in sites MOI/c and BEE VHND @ Service 1. immunization Delivery sites Orientation of RKS June 2011 DPM, MOI/c 0.63+0.20 members Empanelment of May 15 th ADMO(FW) Surgeons 2011 2. Human Identification of NSV /Minilap/ ADMO(FW)/SIH 0.15 Resource trainees and Laparoscope &FW Developme trainers as per the /IUCD nt Plan level of Institutions insertion 3. Service Procurement of the May –July SMO, 2.19 Environme ADMO(FW) & IUCD, Minilap & nt DPM NSV Kit Sterilizers by RKS from their fund 4. Quality Periodicity of the quarterly ADMO(FW) & 0.04 assurance meeting and QAC members aceesement of facility and services 5. Communic ADMO(FW) & ation QAC members

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6. Orientatio quarterly To be included in 20 participants ADMO(FW) & n of GKS capacity each block QAC members volunteers building trg. 7. Sensitizati Monthly on of ,ASHA & AWWS on In sector level ADMO(FW) & non- meeting QAC members clinical contracept ives 8. World Population CDMO & Week July observatio ADMO(FW) n

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At a Glance District Family Planning Annual Plan 2011-12 Sl. Time Activity Responsibility No. Frame 01 . SERVICE DELIVERY Empanellement of Surgeons May 2011 ADMO(FW) Functionalization of FDS Centers June , 2011 MOI/c ,micro plan Organizing NSV/Female sterilization Quarterly ADMO(FW) camps Wider publicity MIE IO, BEE, MOI/c Strengthening and monitoring of IUCD regularly Concerned LHV and MOI/c 02. SERVICE ENVIRONMENT Procurement essentials (kits for July 2011 SMO,DPM, ADMO(FW) minilap, NSV & IUCD) 03. HUMAN RESOURCE DEVELOPMENT Training on NSV,IUCD and Minilap By end of ADMO(FW) & MCH Jan2012 Coordinator Contraceptive update for doctors and 3rd Quarter ADMO(FW) Paramedics 04. LOGISTICS AND SUPPLY SYSTEM Strengthening indenting & supply ADMO(FW) SMS messaging for logistics 05. QUALITY ASSURANCE Regular meetings ADMO(FW) Assessment by QAC members 06. COMMUNICATION ACTIVITIES Publicity about FDS June 2011 MIE IO & BEE World Population week observation July 2011 MIE IO & BEE Orientation of AWW, ASHA,NYK June 2011 MIE IO volunteers 07. PRIVATE SECTOR PARTNERSHIP Involvement of Corporate sectors ADMO(FW) & DPM 08. MONITORING & EVALUATION Review meetings quarterly ADMO(FW) QAC visits Monthly QAC members 09. INNOVATIVE ACTIVITIES IUCD insertion by identifying couples Weekly Concerned LHV, MOI/c having one child and tracking the new couples through ASHA 10 BUDGET Additional budget

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